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美国印第安老年人与白人老年人在预先护理计划方面的差异。

Differences in Advance Care Planning Between American Indian and White Older Adults.

作者信息

Kwak Jung, Cho Young Ik, Lee Yeon-Shim, Noh Hyunjin, Roh Soonhee

出版信息

Res Gerontol Nurs. 2019 Jan 1;12(1):34-43. doi: 10.3928/19404921-20181212-02.

Abstract

Advance care planning (ACP) is understudied among American Indian individuals. A cross-sectional, self-administered survey was conducted with a convenience sample of 200 American Indian and 436 non-Hispanic White older adults from two Midwestern states to identify correlates of ACP. Compared with their White peers, American Indian older adults were significantly less likely to have an end-of-life (EOL) care plan or to have completed a durable power of attorney for health care (DPAHC) or a living will. Multivariate logistic regression showed that having an EOL plan was associated with older age, having some college education or more, and having a greater number of chronic conditions, but not with race. Having a DPAHC was associated with being White, older age, having lower levels of depressive symptoms, and having a greater number of chronic conditions, whereas completing a living will was associated with being White, older age, having some college education or more, and having a greater number of chronic conditions. Nurses need to engage in targeted culturally sensitive approaches to promote ACP, grounded in indigenous cultures' health beliefs and practices. [Res Gerontol Nurs. 2019; 12(1):34-43.].

摘要

在美国印第安人群体中,对临终关怀计划(ACP)的研究较少。我们对来自美国中西部两个州的200名美国印第安老年人和436名非西班牙裔白人老年人进行了一项横断面的自填式调查,以确定与临终关怀计划相关的因素。与他们的白人同龄人相比,美国印第安老年人制定临终(EOL)护理计划、完成医疗保健持久授权书(DPAHC)或生前遗嘱的可能性显著更低。多因素逻辑回归分析显示,制定临终护理计划与年龄较大、接受过一些大学教育或更高学历以及患有更多慢性疾病有关,但与种族无关。完成医疗保健持久授权书与白人、年龄较大、抑郁症状水平较低以及患有更多慢性疾病有关,而完成生前遗嘱则与白人、年龄较大、接受过一些大学教育或更高学历以及患有更多慢性疾病有关。护士需要采用有针对性的、对文化敏感的方法来促进临终关怀计划,这些方法要基于本土文化的健康观念和实践。[《老年护理研究》。2019年;12(1):34 - 43。]

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